Diagnostic Efficacy of Contrast-Enhanced MRI in Detecting Residual or Recurrent Hepatocellular Carcinoma After Transarterial Chemoembolization: A Systematic Review and Meta-analysis
Diagnostic Efficacy of Contrast-Enhanced MRI in Detecting Residual or Recurrent Hepatocellular Carcinoma After Transarterial Chemoembolization: A Systematic Review and Meta-analysis
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对比增强 MRI 在检测经动脉化疗栓塞术后残留或复发性肝细胞癌中的诊断效果：系统评价和荟萃分析
DOI：
10.1002/jmri.26970
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发表时间：
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影响因子：
4.4
通讯作者：
Xing Wei
中科院分区：
文献类型：
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作者：
Liu Hai Feng;Zou Li Qiu;Lu Xing Ru;Sheng Ye;Wang Qing;Ding Jiu Le;Shi Li;Liu Shui Qing;Xing Wei
背景对比增强磁共振成像（CEMRI）在肝动脉化疗栓塞术（TACE）后残留或复发性肝癌（HCC）诊断中的有效性目前尚不完全清楚。目的通过Meta分析探讨CEMRI在TACE后残留或复发性HCC诊断中的有效性。研究类型系统综述和Meta分析。人群在PubMed、Embase、Web of Science、奥维德和科克伦图书馆数据库（截至2019年6月），以查找关于诊断TACE联合CEMRI后疑似残留或复发HCC患者的原始研究。最终纳入了13项研究，共721个结节。场强/序列1.5T或3.0T，CEMRI。评估通过应用诊断准确性研究质量评估-2（QUADAS-2）工具对纳入研究进行质量评估。统计学检验敏感性和特异性采用双变量随机效应模型合并。通过卡方检验评估异质性。结果CEMRI诊断TACE后残余或复发HCC的合并敏感性、特异性、阳性似然比、阴性似然比、诊断优势比和受试者工作特征（ROC）曲线下面积（AUC）为91%（95%置信区间[CI]：87%-96%），93%（95% CI：85%-97%）、12.22（95% CI：5.62-26.57）、0.09（95% CI：0.05-0.18）、126.99（95% CI：34.76-436.99）和0.97（95% CI：0.95-0.98）。亚组分析显示，CEMRI在前瞻性研究中的表现明显优于回顾性研究：0.99（95% CI：0.96-1.00）与0.95（95%置信区间：0.92-0.96），P <0.05.数据结论我们的Meta分析表明，CEMRI在检测TACE后残留或复发的HCC方面具有较高的诊断效率，可作为TACE后HCC的替代方法。TACE后进一步评估。证据等级：5技术有效性：2期J. Magn. Reson. Imaging 2020;52：1019-1028.
BackgroundThe diagnostic efficacy of contrast‐enhanced magnetic resonance imaging (CEMRI) in diagnosing residual or recurrent hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) is currently not completely clear.PurposeTo investigate the diagnostic efficacy of CEMRI in detecting residual or recurrent HCCs after TACE by meta‐analysis.Study TypeSystematic review and meta‐analysis.PopulationA systematic literature search was performed in PubMed, Embase, Web of Science, Ovid, and the Cochrane Library database up to June 2019 to find original studies on diagnosing patients suspected of residual or recurrent HCCs after TACE with CEMRI. Thirteen studies comprising 721 nodules were finally included.Field Strength/Sequence1.5T or 3.0T, CEMRI.AssessmentQuality assessment of the included studies was performed by applying the Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool.Statistical TestsSensitivity and specificity were pooled with a bivariate random‐effects model. Heterogeneity was assessed by the chi‐square test. The potential sources of heterogeneity were explored by subgroup and publication bias analyses.ResultsThe pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic (ROC) curve (AUC) of CEMRI in diagnosing residual or recurrent HCCs after TACE were 91% (95% confidence interval [CI]: 87%–96%), 93% (95% CI: 85%–97%), 12.22 (95% CI: 5.62–26.57), 0.09 (95% CI: 0.05–0.18), 126.99 (95% CI: 34.76–436.99) and 0.97 (95% CI: 0.95–0.98), respectively. Subgroup analysis revealed that CEMRI performed significantly better in prospective studies than in retrospective studies: 0.99 (95% CI: 0.96–1.00) vs. 0.95 (95% CI: 0.92–0.96) withP< 0.05.Data ConclusionOur meta‐analysis suggested that CEMRI had high diagnostic efficacy in detecting residual or recurrent HCCs after TACE and may serve as an alternative method for further evaluation after TACE.Level of Evidence: 5Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;52:1019–1028.